Medication When Used in Conjunction With Counseling Shown to Help Alcoholics Maintain Sobriety

There is no magic pill that can get rid of an alcoholic’s desire to drink. But a couple of FDA-approved medications --- when combined with psychological counseling or support from organizations such as Alcoholics Anonymous --- can be effective in helping people maintain abstinence, researchers reported in the journal JAMA of the American Medical Association.

The drugs, Naltrexone and Acamprosate, reduce cravings for alcohol by fine-tuning the brain’s chemical reward system. Even though the medications could help tens of thousands of alcoholics quit drinking, they are rarely prescribed. As the New York Times reports, they’ve been approved for treating alcoholism for over a decade, but questions about their effectiveness and a lack of awareness among doctors have resulted in the drugs being underused.

In the study, researchers compiled findings from the most rigorous trials of medications for alcoholism in the past few decades. They analyzed data on roughly 23,000 people from 122 randomized trials. The researchers focused on a measure known as the “number needed to treat,” an indicator of how many people need to take a pill for one person to be helped. The study found that to prevent one person from returning to drinking, the number needed to treat for Acamprosate was 12; for Naltrexone, the number was 20. By comparison, large studies of widely used drugs, such as the cholesterol-lowering statins, have found that 25 to more than 100 people need treatment to prevent one cardiovascular event.

The inability to fight off the craving is one of the primary reasons individuals relapse. Which is why these medications, when used in conjunction with behavioral interventions like counseling and therapy, can play such a vital role in helping people maintain their sobriety. And, research has shown that the longer we remain sober, the less likely we are to relapse. In an 8-year study of 1200 addicts, researchers were able to follow up on over 94% of study participants and they found that extended abstinence does predict long-term recovery:

· Only about a third of people who are abstinent less than a year will remain abstinent.

· Less than 50% of people will relapse once they’ve achieved a year of sobriety.

· And once you hit 5 years of sobriety, the chance of relapse is less than 15%.

As Dr. George Koob, the director of the National Institute on Alcohol Abuse and Alcoholism, tells the New York Times, “There are effective medications for the treatment of alcoholism, and it would be great if the world would use them.”

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